Soap Matters - LSHTM

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Saving lives with clean safe care at birth

Three Years On: focus, focus, focus Soapbox was launched in 2012 and three years on, we have learnt a lot and - true to our name – have worked collaboratively, with partners in five low-income countries and in the United Kingdom.

The field has also changed over this time, with more international attention being paid to Water, Sanitation and Hygiene (WASH) in health facilities and with the emergence of antimicrobial resistance as a further challenge to preventing mothers and babies dying of delivery-related infections.

A key question for Soapbox has and always will be “where and how to focus our action and research efforts to bring about the most benefit to mothers and babies?” We have recently taken stock of where next and how to focus further – how to be most cost-effective with Soapbox’s resources and collaborative.

Learning from our experiences and consulting widely, we have now chosen to focus future efforts in three main areas.

In terms of direct action, we will increasingly focus on (1) the challenge of maintaining a hygienic environment, with an initial emphasis on strengthening cleaning practices on maternity units.

To complement and support this work, the research arm of Soapbox will have a two-fold focus: (2) on developing routine sepsis surveil-lance to monitor the benefits of hygiene improvements and also to evaluate new interventions, and (3) on improving hand hygiene practices among health workers and newly-delivered mothers.

We already have exciting initiatives in all three priority areas – with a new cleaning training package ready for piloting, a new systematic review beginning on maternal sepsis related to delivery, and new research about to start in Zanzibar, appropriately called the HANDS study, to under-stand the drivers of hand hygiene and so inform and strengthen interven-tions.

Monitoring our collaborative work, forming partnerships, and raising public awareness of hygiene at birth will, of course, remain core functions for Soapbox. So, the future looks bright ………. and clean!

Prof Wendy J Graham Chief Scientific Adviser & Co-founder of Soapbox

www.soapboxcollaborative.org

Throughout the event Soapbox

invited delegates to write a message

of inspiration to midwives in low-

income countries; we were

overwhelmed by the enthusiasm and

support from everyone who

attended.

The International Day of the Midwife

provides an annual opportunity to

celebrate the work of midwives around

the world. Midwives play a vital role in

providing clean safe care to mothers and

newborns during delivery, making them

crucial in the fight to end preventable

deaths due to infection.

Soapbox works with midwives and other

healthcare professionals in Africa and

Asia to identify, improve and promote

simple, low cost solutions to reduce

delivery related infection which is

estimated to take the life of one mother

or baby every minute.

We were delighted to host a stand at

Robert Gordon University’s International

Day of the Midwife – Celebrating

Women Conference on the 6th May.

International Day of the Midwife

Since its launch in 2012, Soapbox has worked closely with the University and with NHS Grampian, and it was perhaps for this reason that David chose to flag its work, while also a strong supporter of Soapbox’s efforts to involve the next generation of health professionals.

With the amazing sum of over £2000, raised, we are able to strengthen the links with a major hospital and medical school in Ethiopia including providing the opportunity for 2-3 young doctors to visit Aberdeen and gain insights on infection prevention in UK healthcare settings

We extend our sincere thanks to David for his nomination of Soapbox, and to all those making donations. We wish him a colourful third age!

July 31st 2015 was a special day at the University of Aberdeen for many staff – and not just because it was the end of the academic financial year!

For some, it also marked a day of transition into the so-called third age of life (also referred to as “retirement”). And for these individuals, not only was there much to celebrate in terms of long-careers and significant contributions to academia and for some to the NHS, but also in terms of the new and colourful challenges facing them.

Professor David M Reid is one such individual. And his chosen mode for marking his retirement was true to his character — nominating Soapbox to receive donations in honour of his work.

The Soapbox Collaborative @Soapbox_collab

Join the Soapbox team!

Contact us for information about our volunteer opportunities:

Soapbox Ambassadors Soapbox Professionals

Student Forum

info@soapboxcollaborative.org

Issue 10

August 2015

A Generous Departure

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Soap Matters

The Soapbox Collaborative c/o University of Aberdeen Foresterhill Health Centre Westburn Road AB25 2AY, Aberdeen www.soapboxcollaborative.org E: info@soapboxcollaborative.org

Scottish Registered Charity: SC043008

Saving Lives with Clean Safe Care at Birth

Clean, clean, clean Soapbox, in collaboration with UK and overseas partners, has successfully completed needs assessments of maternity units in India, Bangladesh, Zanzibar and Ethiopia. One of the major themes to emerge from the needs assessments and common across countries was the absence of formal, systematic training of domestic services staff (cleaners, ayas, orderlies, ward boys…,) in environmental hygiene and infection prevention and control (IPC). Based on existing national and international guidelines and in consultation with experts in the field, Soapbox is in the process of developing a Core Health Facility Environmental Hygiene Training Manual. The purpose of the manual is to provide information and materials to be incorporated in to training packages developed in our partner countries and tailored specifically for domestic services staff.

Through training, there is a major opportunity to begin to address the poor status of domestic services staff and bring about change and improvement in maternity unit environmental hygiene and IPC, with the ultimate aim of providing clean safe care at birth.

Champions Challenged Award

In June one of our student volunteers, Alex Aulakh, was given an opportunity to represent Soapbox through an internship with WaterAid’s Policy Team in London. Following his placement Alex reported, ‘This was a great opportunity for me to see a different side of international health, I have been involved with some research before, but WaterAid is more of an advocacy and implementation-focused organisation. It is also a non-governmental organisation that operates in the water, sanitation and hygiene sector and I was able to build on my experience of working on hygiene issues with Soapbox in The Gambia’. Soapbox has successfully collaborated with WaterAid for some time and looks forward to continuing this partnership in the future.

Please visit our website at

www.soapboxcollaborative.org

Ethiopia

Baby”, based on WHO guidelines and designed

for use in low-income countries.

This was followed by a further student project,

with Iona Pimentil spending four weeks in the

maternity unit monitoring the use of the WHO

Surgical Safety Checklist in the operating room,

the partograph which monitors progress of

labour, the WHO Safe Childbirth Checklist

which was introduced six months prior and the

obstetric ‘early warning system’ and post-

operative care guidelines, which were

introduced at the start of the year and designed

to aid prompt recognition of unwell mothers.

We are grateful to share their knowledge skills

and time, including Dr. Nicky Carmichael, NHS

Grampian Obstetrics and Gynaecology trainee

and are looking forward to the next busy few

months ahead supporting FHH.

In June we celebrated the first anniversary of our

partnership with Felege Hiwot Hospital (FHH)

situated in Bahir Dar, Nothern Ethiopia, during

which some of our team were able to visit and

witness the continuing improvements being

made at the hospital. The FHH staff are working

towards ambitious goals to improve the health

services they deliver to a population around the

size of Scotland (over 5 million people)!

It has also been a busy summer for our students

visiting FHH’s Maternity Unit. University of

Aberdeen student Anna Rose was first to visit,

spending five weeks on the labour ward. Anna

completed a project observing care of newborns

shortly after birth. The results of this project

were used to form the basis of feedback on the

hospital’s post-delivery care and to introduce a

package from the American Academy of

Paediatrics entitled “Essential Care for Every

The Soapbox Collaborative @Soapbox_collab

Soapbox was delighted to be awarded second place in the academic poster competition at the Champions Challenged Conference in June. This annual Conference held at the Aberdeen Exhibition and Conference Centre is organised by NHS Grampian in collaboration with the Infection Prevention Society. The winning Soapbox poster presented the findings of our feasibility study of clean birth kits conducted in collaboration with the Medical Research Council in the Upper River Region of The Gambia. The study drew comparisons between the uses of clean birth kits given to women during antenatal care compared to those given to women when they arrived at hospital for delivery.

WaterAid Internship

Soapbox is delighted to be holding a Student Innovation Challenge in September. The Challenge has been designed to cultivate the creativity of Aberdeen students to find novel, innovative and low cost solutions to improving hygiene in maternity units in low-income countries. The two day Challenge, which is supported by higher and further education establishments, Aberdeen City Council and businesses across the city will focus particularly on hand hygiene and environmental cleaning the two key areas of interest for Soapbox. See www.soapboxcollaborative.org for booking information (limited spaces available).